Hysterectomy indlela laparoscopic: Isikhathi okuthunyelwe-op, imiphumela ukubuyekezwa. Ukususwa kwezimiso lesizalo fibroids laparoscopically: Izibuyekezo

Okwamanje, sisungule ubuchwepheshe ezintsha evumela ezihlukahlukene kokungenela izifo zabesifazane nge yezinkinga sakugcina nezinga eliphansi ukuhlukumezeka. hysterectomy Laparoscopic ngu - omunye wabo.

Laparoscopy njengoba inqubo entsha

ukuhlinzwa Laparoscopic kade engaphezu kwengu-20. Phakathi nalesi sikhathi-ke umise ngokwaso njengoba indlela kancane koda futhi ngempumelelo yezinkinga sakugcina post-op.

amasu Laparoscopic e zabesifazane kwakuqala ukwanda okungaka. Ngaphambili, indlela enjalo bahlinza izifo zabesifazane amavolumu encane. Kodwa eminyakeni yamuva emitholampilo kanye nasezibhedlela eziningi, sekuvame. Omunye le misebenzi ukususa lesizalo fibroids laparoscopically. Izibuyekezo iziguli abonisa ukuthi kukhona ukubuyiselwa okusheshayo umthamo ukusebenza, ingozi yezinkinga ukuvuvukala umonakalo amancane kancane isikhumba akusho konakalisa ukubukeka abesifazane.

Ngokuba ukusebenza kudinga izisebenzi eziqeqeshiwe futhi waba nayo ngabangane. Ukungenela siyavunyelwa kuleli cala, ukuxakeka omncane. Kwezinye izimo, inhlanganisela laparoscopic nokuhlinzwa ezivamile nje udinga ukulondoloza ukuphila kwesiguli. Lokhu Uchwepheshe ayoyikhetha indlela efanele ukwelapha iziguli zabo uma ngayinye.

Izibhedlela eziningi afeze ukususwa lesizalo fibroids laparoscopically. E-Moscow, cishe njalo umnyango izifo zabesifazane ifakwe imishini ezidingekayo futhi has ochwepheshe sokufeza lokhu zokukhwabanisa. Kuzo zonke ukuhlinzwa izifo zabesifazane 50-60% aphethwe laparoscopy.

Izinzuzo esemqoka indlela:

• ophansi ukubheduka;

• okusheshayo yokutakula umsebenzi zonke izinhlaka;

• Ukuncishiswa ubuhlungu post-op;

• sakugcina ukuvuvukala ;

• nezikhawu ezimfushane esibhedlela;

• ukuhlala ekunakekelweni ngosuku;

• Ukwehliswa ngokuya nokukhubazeka;

• ubuncane hernias nasezinkingeni ezilandela ngemva kokuhlinzwa;

• linanincane lesikhatsi nokuvuselelwa;

• ukulondoloza nemithi.

zikhathi Negative laparoscopy

Woke amahlangothi lawa omuhle ngokuhamba ukuhlinzwa, ephulukisa abesifazane amboze zonke bokwenza ukuthi esivela kunoma iyiphi ukuhlinzwa laparoscopic:

• imishini ukuqeqeshwa ongoti abafanelekayo zidinga izindleko abalulekile;

• Udokotela ohlinzayo ubenawo amasu laparoscopic nokuhlinzwa yendabuko;

• Izinkinga ahlukumeza imisebenzi kwezitho elihlobene ne-umjovo we igesi phakathi komgodi ongaphakathi kwamathumbu, kodwa ukulungiswa futhi ulungise kungagwenywa nokuvimbela lezi yezinkinga;

• Musa siqambe kungenzeka umonakalo mechanical kuya izitho ezihlukahlukene, izicubu kanye nezinhlaka zawo.

Isicelo e zabesifazane

Ngo izifo zabesifazane laparoscopy umkhuba kuyinto ejwayelekile. Ngaphezu uphethwe ezimweni engaqinisekile esiswini oyingozi, ukucacisa izimbangela ukungazali, inqubo laparoscopic isetshenziswa ezimweni ezifana:

1. ukhulela ethunjini.

2. Igebe tube.

3. inzalo Steel.

4. endometriosis.

5. Lesi sifo ingcina.

6. izifo ezihlukahlukene izinhlumba wesibeletho, sklerokistoz, apoplexy wesibeletho.

7. Benign kumiswa kwesibeletho (hysterectomy amasu laparoscopic kunciphisa ingozi yokuthola nasezinkingeni ezilandela ngemva kokuhlinzwa).

8. hyperplastic izinqubo, hhayi amenable yokwelapha olandelanayo.

Okusanda gynecologists evame ukusetshenziswa hysterectomy laparoscopic ngisho izimila ebulalayo. Ubani asungula izindlela eziningi kulo msebenzi, kuye ngokuthi ungakanani kwesibeletho, isimo salo futhi bayabandakanyeka inqubo kwezitho engumakhelwane. Kabanzi fibroids lo msebenzi nganoma kwasendaweni ezahlukene.

lesizalo fibroids

Lesizalo fibroids - isifo ingozi lapho ngaphansi kwethonya hormone kwenzeka ekwandeni izicubu fibrous kumiswa ifindo. It yabukela ovame kakhulu lesi sifo - 25% azo zonke izinkinga gynecological. fibroids lesizalo kunemtselela kwayo yonke indikimba yezikhonzi abesifazane. Myomectomy kubhekwa ekwelapheni "standard igolide" lesi sifo.

Hysterectomy laparoscopically. izinhlobo

Lapho ekhetha indlela kuhlinzwa ekwelapheni fibroids is kunakwe izici eziningi: indawo kanye nosayizi ISIZINDA, ukusebenza, noma ukulahleka izitho eduze, isimo jikelele owesifazane. Kuye lesizalo izilonda ezihlobene kukhona izinhlobo eziningana ukuhlinzwa ezithweni zokuzala.

Ngo umkhuba isebenzisa:

- hysterectomy Imininingwane lapho kususwe umzimba futhi wesibeletho; subtotal - kwesibeletho sisuswa emzimbeni. Uma kanye kwesibeletho ipayipi unqanyulwe - gistertubektomiya, futhi uma amaphayiphi kanye Yachnik, operation ezifana libizwa gistertubovarioektomiya. Ukuze imisebenzi olukhulu ezifana pangisterektomii - susa yonke zangasese yangaphakathi kanye izindlala zamanzi noma nezindlala kwezicubu sangasese futhi ngokwengxenye yakhetha izinqubo oncological ezizungezile.

- Lapho nengcosana amayunithi futhi ukulondoloza yokuzala abesifazane ukuhlinza ablative. Omunye walena uwukuba ukususwa subserous lesizalo fibroids laparoscopically. Nge okuncane lesizalo lesion eyenziwa enucleation ISIZINDA, isb husking izicubu fibrous ne okwalandela ekulondolozeni isitho. Ngemva le misebenzi, owesifazane ungathola abakhulelwe emva kwesikhathi esithize futhi ubelethe.

Izimo

Kukhona Izimo ukuhlinzwa ukususa fibroids kwesibeletho laparoscopically. Izibuyekezo gynecologists kusikisela ukuthi ezimweni eziningi ukusebenza kungaba kwenziwe zonke except for labo abesifazane abaphethwe zenhliziyo ezinzima, nokuvaleka kwemigudu yokuphefumula, abe umbhunu, izinkinga ababa nazo ohlelweni igazi coagulation noma marasmus

Izimo Isihlobo - isimo lapho i operation kungenzeka, kodwa siveza obuthile. Ziyakwazi:

• kakhulu liphinyiselwe amafutha ongama;

• izifo ingelashwa samafayela;

• ukuvuvukala;

• effusion noma khona uketshezi ngaphakathi komgodi ongaphakathi kwamathumbu of abangaphezu kuka-1 litre.

Kodwa gynecologists yesimanje, kokuba inqubo laparoscopic, ngemva ngokuhlola ezinye izifo ezifana ebekiwe imithi oyinikiwe, sanitize foci ukutheleleka futhi afeze ukuhlinzwa. Ngesikhathi esifanayo bakale "kochwepheshe" futhi "nebubi" ngaphambi uchitha operation laparoscopic.

Ukulungiselela ukuhlinzwa

Uphenyo abesifazane abaye zabhekana hysterectomy laparoscopically, kuyaziwa ukuthi iziguli unganelisekile kuphela nokulungiselela: Ukusebenza ihlala imizuzu 40, kanye nokulungiselela - 2 amaviki nokuningi.

On operation owesifazane kufanele ize ngemva ukuhlolwa futhi imiphumela eyatholakala izothunyelwa:

• Ukuhlolwa kwegazi (inani, kwamakhemikhali, lwegazi nomaka RH isici, ukusha kwesibindi kohlobo, ugcunsula kanye ekunqandeni-HIV, ukunqunywa glucose);

• Umchamo ukuhlolwa - jikelele futhi ukuzimisela ushukela;

• smear;

• electrocardiogram;

•-x-reyi,

• ultrasound;

• colposcopy;

• Ukuhlolwa ongoti: owelapha, uma kunesidingo, wenhliziyo nabanye.

Ngaphambi ukusebenza iziguli lesizalo fibroids kudinga curettage ahlukene zokuxilonga kwesibeletho futhi ukuthola imiphumela histological. Lokhu kuyadingeka ukuze kulungiswe udaba inani ukuhlinzwa nekugwema futhi kuvimbele ukuqhubeka izinqubo umdlavuza.

Zonke izivivinyo - inqubo kudingekile, futhi kuphela ngemuva kophenyo egcwele udokotela ohlinzayo bazokwazi ukufeza ukususwa kwesibeletho laparoscopically.

Ngosuku olwandulela ukuhlinzwa is hhayi Kunconywa ukuba adle, kufanele aphuce izinwele pubic.

Ngaphambi kokuba ahlinzwe, owesifazane igcwalisa ifomu imvume yokubulala izinzwa, futhi eceleni izindleko zokuhlinzwa kwakho. Uma kudingeka, ukunikeza ukulungiselela yezokwelapha noma psychoprophylactic ukuhlinzwa.

ukusebenza Technology

Ukusebenza ukususa kwesibeletho laparoscopically asenza lapho myomas osayizi amasonto 16 okukhulelwa, okuyinto nzima ukopha, libhekene ukukhula ngokushesha noma ingozi ukuguqulwa ebulalayo. Nakuba abanye ochwepheshe abanolwazi lususwe kwesibeletho, usayizi okuyinto-20 amasonto. Kodwa ngokuvamile, uma kubhekwa iminyaka yowesifazane, eyenziwa ukususwa lesizalo fibroids kokushiya laparoscopically ingxenye encane kwesibeletho ngoba esikhathini.

Sebenzisa ezintathu noma ezine wokubhoboza odongeni kwamathumbu (i - eduze inkaba kanti lawa amanye amabili - ohlangothini ngalunye) kanye trocars iqondiswa. Le divayisi unikezwe ikhamera ukuqapha ukukhanya noma nge ukufakwa supercharger carbon dioxide noma i-nitrous oxide namathuluzi.

Ngemva ukususwa wokuhlola okwenziwa fibroids laparoscopically lesizalo. Ngenxa yalesi umsipha is excised, izitsha ligated dissected ezingadingekile esibelethweni futhi odongeni emomozini isuswe ngokusebenzisa sangasese esebenzisa sebeziqhumbuza lezi vaults. Lo msebenzi elibizwa laparoscopically basiza myomectomy lwesitho sangasese sowesifazane. Chitha suturing sebeziqhumbuza sangasese. Ngo operation eyodwa zingase zisuse ISIZINDA amaningi ngaphandle kabusha kokungenela.

Ngemva odalyayut igazi noma uketshezi, zanqwabelana ngesikhathi ukusebenza, ukuhlolwa Kwenziwa futhi imizimba futhi izindonga komgodi ongaphakathi kwamathumbu. hlola ngokucophelela ukuthi wabopha kahle futhi ligated izitsha, kungakhathaliseki propotevanie igazi noma uketshezi lymph. Ukuphungula igesi futhi ukubonisa amathuluzi. Khona-ke yaseZimbabwe kwenzeka esikhumbeni nezicubu ongama endaweni trocar, isikhumba sutured sutures yezimonyo.

Isikhathi operation ingase kusuka imizuzu engu-15 1.5 amahora kuya ngevolumu ka wachitha kokungenela kuhlinzwa.

Analgesia ekusebenzeni ezifana nokususwa kwesibeletho laparoscopically: Izibuyekezo

Yini izinzwa kungcono? Lo mbuzo kufanele ingaxazululwa kanye udokotela ohlinzayo ongudokotela obulala izinzwa, unikezwa isimo jikelele isiguli, izinkomba izifundo laboratory, ivolumu elilinganisiwe imisebenzi. Ezimweni eziningi, le kuhlanganiswe izinzwa endotracheal. Uphenyo abesifazane bathi it is ibekezelelwe kahle, kungekho ikhanda. wake Female emva kwemizuzu 15-20 emuva kokuhlinzwa ezifana nokususwa kwesibeletho laparoscopically.

Isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa nge izinzwa efanele kuholela nemiphumela emihle ngemva kokungenela: ubuhlungu akazihluphi, kukhona ukungakhululeki ezincane kuphela, okuyinto sidlula izinsuku 2. Ngezinye izikhathi kungaba isicanucanu, kodwa iboshiwe "metoclopramide". Ngosuku lokuqala ungakwazi uphuze amanzi kuphela. Kusihlwa, ungakwazi kakade sukuma uvuke. Ngosuku lwesibili nawe ungadla, okungadingi obulimaza wamathumbu, ezifana iphalishi, amasobho, nemikhiqizo yobisi. Lombhalo ucashunwe ebhukwini Kwenziwa ngosuku lwesibili ngemva kokungenela, futhi ilivu yokugula ivaliwe emva kwezinsuku ezingu-30. Ngemva kwalokho owesifazane elingangena ngokuphepha ngiye emsebenzini, kodwa ukuvinjelwa okhandlayo esindayo inyanga. Sutures ziyasuswa ngosuku nasezinkingeni ezilandela ngemva kokuhlinzwa 5.

Ngemva kokuhlinzwa, ngenxa yezinkinga kungenzeka, okuyizinto ezingavamile: lokhu ukulimala trocar izitho zangaphakathi, ngopha ngaphansi izitsha ligated, emphysema ongama. Konke lokhu kungagwenywa uma banamathela ukusebenza imishini futhi wenze ehloliwe ngaphakathi komgodi ongaphakathi kwamathumbu ngokucophelela.

imiphumela

Kufanele kuqashelwe ukuthi emuva kokuhlinzwa ezifana indlela laparoscopic hysterectomy, imiphumela beba. Yokutakula kwenzeka emva 2 amaviki ukuvuselelwa. izinsuku ezingu-30 ngemuva kokuhlinzwa owesifazane angaya mayelana nebhizinisi yabo njengokujwayelekile. Kunconywe umsebenzi ingenzeka. Kodwa kamuva ngenyanga, kuba engathandeki ukulayisha imisipha besisu, phakamisa izisindo ilanga.

Ezinsukwini zokuqala bangezwa izinhlungu ezincane ukubelesela esiswini. Lokhu kuvamile futhi okufanele idlule kwezinsuku ezingu-1-2. Ukwakheka ukuvuvukala kungenzeka, kodwa ngokusho izibalo lokhu kwenzeka kakhulu kuyaqabukela futhi kuphela yofuzo umzimba noma ngaphansi i-endometriosis wazwakalisa.

Iya kancane osenyameni evela ipheshana zangasese. Lokhu kuvamile uma ezikhiqiza amaqanda kuyagcinwa. Bayaqhubeka ukukhiqiza ama-hormone ezibangela lesi simo.

Amacala izinqubo ukuvuvukala emva kokuhlinzwa laparoscopic ezingajwayelekile, ngoba antibiotic esimisiwe ngokushesha ngemva kokungenela nokuqhubeka izinsuku 5. Ngesikhathi esifanayo ke ukulungiswa kwamanzi kanye electrolyte yokwakheka igazi.

Kubuyiselwe nesineke wenzalo cishe ngokushesha, kodwa kwezinye izimo kukhona ukwanda libido. Owesifazane angaphila ukuphila ngokocansi emva 1 inyanga ngemva kokuhlinzwa. Uma umzimba lilondolozwe, ungathola abakhulelwe phakathi nezinyanga eziyisithupha ngemva kokungenela.

Ngingalutholaphi afeze ukuhlinzwa?

Izibhedlela eziningi banganikeza hysterectomy laparoscopically. E-Moscow izibhedlela idolobha anemisila imishini futhi babe Ochwepheshe abazi le ndlela ngeke ukukunikeza lawa masevisi. Intengo kokwenziwe wavumelana udokotela ukuba khona.

Ucwaningo kungenziwa ehhovisi noma lokuhlala zangaphambi esibhedlela. Ukuze siqhube imisebenzi enjalo ingenzeka yokubhalisa quota. Izindleko hysterectomy laparoscopic imayelana 45 kuya kwezingu-70.